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目的:探讨不同体重指数(BMI)的多囊卵巢综合征(PCOS)患者的彩色多普勒参数与糖代谢指标的相关性。方法:选取就诊的初诊PCOS患者108例,按BMI分为<23kg/m2组(正常体重组,31例)、23~24.9kg/m~2组(肥胖前期组,19例)、≥25kg/m~2组(肥胖组,58例)。监测3组患者的糖代谢指标和彩色多普勒参数,分析各组患者超声参数与糖代谢各指标之间的相关性。结果:与正常体重组相比,肥胖前期组的胰岛素释放试验异常率显著增加(P<0.05),而超声参数无差异;肥胖组的胰岛素释放试验异常率及糖耐量异常率(IGT)均显著增高,超声参数卵巢体积(OV)显著增高,搏动指数(PI)显著降低,差异有统计学意义(P<0.05)。相关性分析显示,正常体重组患者的彩超参数与各糖代谢指标无显著相关;肥胖前期组的OV与卵泡个数(FN)均与2h血浆血糖(PG)呈正相关,PI与1h PG、葡萄糖曲线下面积(GAUC)、1h胰岛素(INS)、胰岛素曲线下面积(IAUC)呈负相关;肥胖组PCOS患者OV与1h PG、1h INS呈正相关,FN与FINS、1h INS、2h INS、IAUC呈正相关,Vs、Vd与2h PG呈正相关,PI、RI均与2h INS、IAUC呈负相关。结论:肥胖PCOS患者彩色多普勒超声参数与糖代谢指标具有明显的相关性。
Objective: To investigate the relationship between color Doppler parameters and glucose metabolism in patients with polycystic ovary syndrome (PCOS) with different body mass index (BMI). Methods: A total of 108 newly diagnosed PCOS patients were selected and divided into 23 kg / m2 group (normal weight group, 31 cases), 23-24.9 kg / m2 group (19 cases of obesity group), 25kg / m ~ 2 group (obesity group, 58 cases). The glucose metabolism parameters and color Doppler parameters were monitored in 3 groups of patients, and the correlation between ultrasound parameters and each index of glucose metabolism was analyzed. Results: Compared with normal weight group, the abnormal rate of insulin release test in pre-obesity group was significantly increased (P <0.05), but there was no difference in ultrasound parameters; the rate of abnormal insulin release test and IGT in obesity group were significantly The ovarian volume (OV) and the pulsatility index (PI) of the ultrasound parameters were significantly increased (P <0.05). Correlation analysis showed that there was no significant correlation between the color Doppler parameters and the indexes of glucose metabolism in normal weight group. There was a positive correlation between OV and follicle number (FN) and 2h plasma glucose (PG) in early obesity group, PI and 1h PG, glucose The area under the curve (GAUC), 1h insulin (INS) and the area under the curve of insulin (IAUC) were negatively correlated. In obesity group, OV was positively correlated with 1h PG and 1h INS, while FN was positively correlated with FINS, 1h INS, 2h INS and IAUC Correlation, Vs, Vd and 2h PG was positively correlated, PI, RI and 2h INS, IAUC was negatively correlated. Conclusion: The color Doppler ultrasound parameters of obese PCOS patients have obvious correlation with the indexes of glucose metabolism.